Medications:

What I am on: (So to speak)

Regarding the Lipitor: [update 31 Jan 2013]

After a short time. a medical advisor queried my behaviour regarding awareness and comprehension and suggested a possible reaction to the statin. A trial period seemed to support this possibility. A groin pain also caused thoughts of a connection but that has not been confirmed.

The MD suggested a different brand of statin but I have been scared off.

My cardiologist has recommended continuation of a small dose but, again I have now read so much medically valid information that I am prepared to gamble my well-being on reliance on excercise, diet and daily intake of pomegranate juice. Plenty of apples and watermelon also. On the other hand I tend to be slack with this regime. Only the pomegranate juice is religiously adhered to.

I am hoping to obtain another CT Angiogram to assess my current arterial blockage status.

Atorvastatin is a cholesterol-lowering medication that blocks the production of cholesterol (a type of fat) in the body.

Atorvastatin reduces low-density lipoprotein (LDL) cholesterol and total cholesterol in the blood. Lowering your cholesterol can help prevent heart disease and hardening of the arteries, conditions that can lead to heart attack, stroke, and vascular disease.

Atorvastatin is used to treat high cholesterol. Atorvastatin is also used to lower the risk of stroke, heart attack, or other heart complications in people with coronary heart disease or type 2 diabetes.

Atorvastatin may also be used for other purposes not listed in this medication guide.

What are the possible side effects of atorvastatin (Lipitor)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using atorvastatin and call your doctor at once if you have any of these serious side effects:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about atorvastatin (Lipitor)?

In rare cases, atorvastatin can cause a condition that results in the breakdown of skeletal muscle tissue. This condition can lead to kidney failure. Call your doctor at once if you have unexplained muscle pain or tenderness, muscle weakness, fever or flu symptoms, and dark colored urine.

This medication can cause birth defects in an unborn baby. Do not use if you are pregnant. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment.

Do not take atorvastatin if you are pregnant or breast-feeding, or if you have liver disease.

Before taking atorvastatin, tell your doctor if you have diabetes, underactive thyroid, kidney disease, a muscle disorder, or a history of liver disease.

Avoid eating foods that are high in fat or cholesterol. Atorvastatin will not be as effective in lowering your cholesterol if you do not follow a cholesterol-lowering diet plan.

Avoid drinking alcohol while taking atorvastatin. Alcohol can raise triglyceride levels, and may also damage your liver while you are taking atorvastatin.

There are many other drugs that can interact with atorvastatin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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Brilinta

What is BRILINTA?

BRILINTA is a type of prescription antiplatelet medication for people who have had a recent heart attack or severe chest pain that happened because their heart wasn’t getting enough oxygen and who are being treated with medicines or procedures to open blocked arteries in the heart. BRILINTA is used with aspirin to stop platelets from sticking together and forming a blood clot that could block blood flow to the heart and cause another, possibly fatal, heart attack. Platelets are small cells in the blood that help with normal blood clotting.

Take BRILINTA and aspirin exactly as instructed by your doctor: BRILINTA twice a day, plus one 81-mg aspirin tablet once a day. You should not take a dose of aspirin higher than 100 mg each day because it can affect how well BRILINTA works. Tell your doctor about any medicines you are taking that contain aspirin. Do not take any new medicines that contain aspirin.

Side-effects and/or dangers.

BRILINTA can cause serious side effects, including bleeding and shortness of breath. Call your doctor if you have new or unexpected shortness of breath or any side effect that bothers you or that does not go away. Your doctor can decide what treatment is needed.

BRILINTA (and similar drugs) can cause bleeding that can be serious and sometimes lead to death. Instances of serious bleeding, such as internal bleeding, may require blood transfusions or surgery. While you take BRILINTA, you may bruise and bleed more easily and be more likely to have nosebleeds. Bleeding will also take longer than usual to stop.

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Coversyl

Initially supplied as ‘Perindopril Argenine’, apparently now no longer available.

How does it work?

Coversyl arginine tablets contain the active ingredient perindopril, which is a type of medicine called an ACE inhibitor. (NB. Perindoril is also available without a brand name, ie as the generic medicine.)

ACE inhibitors work by blocking the action of a compound in the body called angiotensin converting enzyme (ACE). Normally ACE produces another compound called angiotensin II, as part of the body’s natural control of blood pressure. Angiotensin II causes blood vessels to constrict and narrow, which increases the pressure within the blood vessels.

As perindopril blocks the action of ACE, it reduces the production of angiotensin II. This means that the blood vessels are allowed to relax and widen. The overall effect of this is a drop in blood pressure, hence perindopril can be used to lower high blood pressure.

The reduced pressure within the blood vessels means that the heart doesn’t have to work as hard to pump the blood around the body. This means that ACE inhibitors can be used to improve the symptoms of heart failure, where the heart is not pumping as efficiently, and to improve survival following a heart attack.

It is recommended that Coversyl arginine tablets are taken in the morning before breakfast.

What is it used for?

Reducing the risk of further heart attacks in people with stable coronary heart disease who have had a heart attack or heart bypass surgery.

Warning!

Some people may experience dizziness caused by low blood pressure in the first few days of taking this medicine and in particular the first dose. For this reason, the first dose should preferably be taken at bedtime. Your doctor may want you to take the first dose of this medicine under medical supervision in hospital if you are aged over 70 years, have low blood pressure, low levels of fluids or salt in your blood (eg due to dehydration), severe or unstable heart failure, kidney problems, or are taking high doses of diuretic medicines, multiple diuretic medicines, or certain other medicines that dilate your blood vessels.

If you feel dizzy during treatment this can be relieved by lying down until the symptoms pass. If affected you should avoid performing potentially hazardous tasks such as driving or operating machinary. If you frequently feel dizzy you should let your doctor know, as your dose may need reducing.

Alcohol may enhance the blood pressure lowering effect of this medicine, which can increase dizziness and may increase the risk of fainting.

ACE inhibitors can sometimes cause an allergic reaction called angioedema. Stop taking this medicine and consult your doctor immediately if you experience difficulty breathing or swallowing, or swelling of your face, lips, tongue, throat, hands, feet or ankles while taking this medicine. This type of allergic reaction has been reported more frequently in people of Afro-Caribbean origin.

Your blood pressure, kidney function and the amount of potassium in your blood should be regularly monitored while you are taking this medicine.

Use with caution in

Elderly people.

Decreased liver function.

Decreased kidney function.

Narrowing of the arteries that supply blood to the kidneys (renal artery stenosis).

High blood pressure caused by compression or blockage of the arteries that carry blood to the kidneys (renovascular hypertension).

People with low fluid volume or salt levels in the body, eg due to diuretic therapy, low-sodium diet, diarrhoea or vomiting.

People taking other medicines for high blood pressure, particularly diuretics (see end of factsheet).

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Published problems and criticisms of prescribed medicines:

Aspirin: (blood thinning agent)

The catch is that there really is no safe dose of aspirin.

Aspirin (acetylsalicylic acid) is a synthesized version of a compound originally discovered in willow bark. One of the more common dangerous side effects of the regular use of aspirin is intestinal bleeding. Other side effects include ulcers, kidney dysfunction, and stroke. Here are just a few indications of how harmful aspirin can be: * Researchers from Virginia Medical School, who examined medical records of hospital deaths, estimated that the drug is killing around 20,000 in the US alone. * Randomized clinical trials testing aspirin in 5011 elderly people showed that use of aspirin caused a 4-fold increase in hemorrhagic stroke and a 1.6- to 1.8-fold increase in ischemic stroke. * As noted in the 1999 Associated Press article titled “The Silent Epidemic”, death by analgesics (over the counter pain killers such as aspirin and other NSAIDs) is the 15th most common cause of death in America. * The American Journal of Medicine reported that conservative calculations estimate that approximately 107,000 patients are hospitalized annually for NSAID-related gastrointestinal complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone * Each year 1600 children with Reye’s syndrome and other allergies die from taking aspirin. * Rather than being a nutrient, aspirin is an anti-nutrient. It depletes the body of life-saving nutrient folic acid as well as iron, potassium, sodium, and vitamin C. Symptoms of folic acid depletion include anemia, birth defects, elevated homocysteine (itself a significant heart disease risk factor), fatigue, headache, insomnia, diarrhea, increased infection and hair loss. Millions of people already take daily aspirin due to doctors’ advice and mainstream propaganda that daily aspirin will prevent heart attacks and strokes. What aspirin does is enable thinner blood to be more easily pushed through clogged arteries. When it comes to preventing cancer, strokes, heart attacks and other illness, by far the best and healthiest plan is to eat a healthy diet and lead an active and healthy lifestyle.

“There’s a good chance that you have been diagnosed with “high” cholesterol, or that you will be soon—between 30 and 40% of American adults have LDL cholesterol of 130 or higher, and women usually experience a spike after menopause. And when that diagnosis comes, most doctors will pull out a prescription pad to get you started taking one of the cholesterol-lowering drugs known as statins. In general, the medical community seems to love these drugs. One doctor I interviewed called statins “the wonder drugs of the 21st century” because they “save millions of people’s lives.” And the most authoritative health organizations around, including the American Heart Association, have endorsed them.

However, a small but impassioned segment of the medical community believes that statins don’t help cardiovascular health at all, and that they may do more harm than good. You can find a lengthy, well-articulated summary of the argument against statins in this article in Experience Life magazine—do take a look at it if you’re on statins or thinking about starting them. The upshot of the article is that high LDL cholesterol isn’t the cause of heart disease but simply a marker of the inflammation that is the true cause most illness, cardiovascular and otherwise. The piece quotes one doctor as saying:

In other words, using drugs to force cholesterol lower won’t improve heart health and might worsen it if your lower LDL numbers lead you to indulge in more inflammation-causing foods and slack off on exercise. Plus, the side effects of statins can be serious: Diabetes, muscle pain, and memory loss to name a few.

Okay, I have to emphasize that the anti-statin argument is controversial stuff, but that said, none of the sources quoted in the piece could be considered fringe—we’re talking MDs and PhDs, no acupuncturists or Reiki healers in the bunch. And even if these statin-doubting doctors are dead wrong about their core idea, and high cholesterol is the cause of heart disease, and that lowering it by any means is a good thing, questions still remain about whether statins should be as broadly prescribed as they are. This article in Timeexamines evidence that statins don’t prevent heart attacks in otherwise healthy people (and are only beneficial to those who already have true heart disease), that they’re less useful to women than they are to men, and that women suffer more severe side effects.”

Coversyl

Keyword: patent Mum’s being switched to a different medication for her blood pressure. Not by her doctor, though, and not for any medical reason. Indeed, the information she got at the pharmacy made it seem like it’s the same medication only in heavier dose — only a careful comparison with the old box revealed the difference in active ingredient (from Perindopril Erbumine to Perindopril Arginine). The name change — and the change as explained in the leaflet — was from “Coversyl 8mg” to “Coversyl 10mg”.

Why?

Well, apparently the patent on the old medicine was running out in a couple of months. By changing the formulation, the pharmaceutical company gets another 15 years. Evergreening, this is apparently called. There is an official benefit to the new formulation, but it’s phrased so contingently (‘potentially … longer expiry date’) that it would seem to be limited if it exists at all.

So here’s mum being forced onto a new medicine for no reason better than corporate greed.

Of course, the whole system of medicine patents suffers from one logical flaw: developing new medicines is important, but hardly the only area of medical research. How are the other areas financed? Either they are financed well enough, in which case the same mechanism can be used to finance development of new medicines; or they are not financed well, which is a real problem that needs to be solved urgently. In neither case are medicine patents of any real use to society.

2 February 2007, 3:13 UTC comment by Sue Hi – I am a patient using this drug too. I wondered if your Mum was having any adverse affects? I am also on the 10mg. I am having headaches since the changeover. Interesting and very plausible view you have put forward also. Regards, Sue.

20 April 2007, 20:15 UTC comment by Kay Hi, I had been on Coversyl 8mg for a few years with no ill effects. However, after switching to the Coversyl 10 mg, my Liver enzyme results went through the roof. I am not talking a little, I am talking of readings that were elevated of more that 100-200 above what they had been. After investigating to see what was causing it, there was a direct correaltion between when switching to the Coversyl 10mg and the elevation in readings. The reverse happened when I was changed off the Coversyl 10mg. It was discovered I was sensitive to the changed active ingredient ‘Arginine’. So much for being told the 10 mg was exactly the same as the 8mg!!!!

27 July 2007, 8:05 UTC comment by JT Are you all aware that Arginine is inactive? It cant actually cause anything and is excreted unchanged? The TGA is very strict and demanded the toughest guidlines before the drug came out. I got switched from 8mg to 10mg and if you look closly the only think that has changed is the packet, also the generic is out so wheres the evergreening oh and the company is a foundation and now donates 100% of its turnover to charities and communities and also research. In case your wondering i work for a GP and get to read all the boring papers left bheind.

27 July 2007, 9:11 UTCcomment by sabik @JT: I find that very hard to believe.

Firstly, the question isn’t about Arginine, but about the difference between the two salts of Perindopril, Perindopril Erbumine and Perindopril Arginine. Salts generally have very different properties to their constituents.

22 October 2007, 14:27 UTC comment by Aching I was switched to the new formulation and suffered facial flushing, going bright red within several hours of taking the 5mg tablet each morning and having to cool my face with water to ease it. I put in an adverse reaction report to the TGA in Aust. Arginine is a vasodilator, not an inactive substance. I am in my early 50’s but I experienced constant shoulder myalgia and calf muscle cramps on the original Coversyl and now on the new formulation I currently have acute inflammatory arthritis of the hands, hips, knees and feet for which I am being tested and treated. I intend to change to the original formulation as soon as I can obtain it or will probably cease Coversyl.

13 December 2007, 11:46 UTC comment by maureen I have submitted an adverse reaction report to ADRAC and to Servier over the reformulated Coversyl. My 90yo mother experienced extreme and disabling vertigo every day she was on the new 5mg formulation. I insisted she be changed back to a generic with the 4mg erbumine salt: the vertigo gradually faded away, over a period of 5 days before she was completely free of any dizziness and woke up “feeling normal.” Subsequently she has had no vertigo except for one day when she missed taking her tablet (I found it on the floor next day). About a month later she saw a specialist who decided to swap her to Atacand so the experiment will not be repeated, but watch out and let us know if dizziness is a result, and hip fractures as a result of the vertigo would be likely. Her GP initially thought this was just another symptom of old age. All ingredients are of significance, not just those the company claims to be the therapeutic ones.

21 February 2008, 10:36 UTCcomment by Aching I have stopped the reformulated Coversyl, changing to Perindo which is now available. It has the same formulation as the original Coversyl: perindopril erbumine, not perindopril arginine. I heard from the pharmacist that Perindo was now available, but requires a replacement prescription. After a year of constant pain, within 4 days the severe myalgia stopped. And I’m not stiff and sore when I wake in the morning now. If anyone else is being crippled by muscle pain while on Coversyl, it may be a side effect.

17 March 2008, 10:11 UTCcomment by pain I was swithched from 5mg coversyl to 10mg and I have experienced abdominal pain since {2 months} My doctor is running tests and disreguards that it could be a side effect. Though it is a big co-incidence. Any comments?

14 May 2008, 2:27 UTCcomment by paul I have not taken the ‘new’ (arginine) formulation of Coversyl as I have a backlog of filled scripts (some are now of the ‘new ‘formulation), but the latest supplies, in response to a script. for Coversyl, have been changed by my pharmacist to GenRx Perindopril-4ml. perindopril erbumine. Just luck I suppose, or a wide awake pharmacist!!

17 August 2008, 5:32 UTCcomment by lance I am 76Years of age and my doctor put me on coversyl-10 about 5 months ago, I now have a heart that is intermittent and up until coversyl had a very strong heart. I feel like I have been put through the wringer and I am about to give it the flick and go on alternative medicine. I think that the Pharmaceuticals Suck.

25 October 2008, 6:03 UTCcomment by xmrjeep I had been on the original Coversyl for 4 years. After one prescription I started to suffer muscle pain in my upper thighs, an inspection of the box revealed I had been prescribed generic Perindopril not the original,a very clever copy of the old box was the culprit. I changed back immediatley and the problem disappeared. Since then I was given the new Arginine salt, within a month the side effects returned and are getting worse in addition I am experiencing muscle pain at the back of my neck. I am being changed to an entirely different ACE inhibitor despite the fact my GP believes they are the same product. I have been conned for the convenience of the drug companies!

15 November 2008, 0:04 UTCcomment by Chris i have been on coversyl 5 mg to control kidney function (bergers disease) but have since switched to 10 mg Arginine due decreasing kidney function resulting from hypertension. i also had a few side effects constant dry cough and nausea and sudden severe cramping in the thighs and calves, believed that this was something that i would have to live with. id like to hear from younger people, i am 29, who have the same problem and what sort of results they have had from using this drug.

25 November 2008, 13:14 UTCcomment by Hendrik My GP prescribed Conversyl 10mg recently. I have suffered from severe maylgia over the last two weeks, to such an extent that I have been unable to sleep for a few nights. My doctor told me today to staop taking the tablets. Hopefully the pain will go away soon.

9 January 2009, 3:54 UTCcomment by KChin My nephrologist put me on 2mg Coversyl daily for the last 6 years to protect my kidneys since I have micro hematuria, but I do not have hypertension. I have now developed Oral Lichen Planus. I wonder if Coversly is the cause of this problem.

23 April 2009, 3:15 UTCcomment by Tyna My mother is 82 and has been on coversyl for many years. Having recently moved to an aged care facility, the visiting doctor prescribed GX Perindopril/Indapamide instead. She has suffered swollen, painful feet for the first time in her life. It was just luck that I realised the two were linked. It really peeves me that the change was done due to a cheaper generic version of the original. Surely there is no need to do this, especially when the government subsidises the correct medication anyway. Just another area where the elderly are disrespected in my view. She was not even given a choice. Getting old sucks, as I can see it…. Thanks for everyones comments on this site, it made me realise that I wasnt just imagining the link.

27 April 2009, 1:38 UTCcomment by kirsten I have been on Coverysl 5mg the Perindopril Arginine one for about 1 year and am having increasing neck, shoulder pain, and it feels like it is slowly moving down my back. Does this sound familiar to anyone? NOt that Ive had arthritis before , but I imagine this might be how it feels. If you change medication do the pains go Away?

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4 Responses to Medications:

I cannot let the Australian reneerfce pass without comment!There has been no “work carried out by the Australian government”. In fact, the bioequivalency of the erbumine and argenine salts was demonstrated by LLS itself, which facilitated the approval and listing of the new formulation for use in Australia.The prices are the same again because of voluntary action by LLS. Had LLS wanted to charge more for the new COVERSYL it could have done so, but the government would then presumably not have agreed to subsidise it under the Pharmaceutical Benefits Scheme (PBS) when there were cheaper generic alternatives available.Whether this reflects “robustness” of the Australian system is no doubt a matter for debate.I am unaware of any reason to suppose that the claims of improved shelf-life for the arginine salt are untrue, and indeed I can only assume that the allegedly “evergreening” patent would not have been granted without empirical evidence of this fact. Certainly in the Australian context improved longetivity in “extreme” conditions is a genuine advantage. Indeed, it might even have justified a slightly higher price per unit, considering the potential savings in transport and storage.By way of comparison, Australian consumers can expect to pay up to $17.63 ( 10.85) for 30 Coversyl 2.5mg or generic Perindropril 2mg; up to $23.04 ( 14.19) for 30 generic Perindropril 4mg (I could not find a listing for Coversyl 5mg, so it may not be available here); and up to $29.24 ( 18.00) for 30 Coversyl 10mg (no generic equivalent listed in this dosage).These are PBS-subsidised prices, so the Australian taxpayer is also contributing. It therefore seems that whichever brand you choose, the British consumer is doing better than the Australian, despite our allegedly “robust” system.Swings and roundabouts, perhaps?

If you’ve ever had muscle spasms or muscle cramps, you know they can be extremely painful. In some cases, a muscle may spasm so forcefully that it results in a bruise on the skin. Most muscle spasms and cramps are involuntary contractions of a muscle. A serious muscle spasm doesn’t release on its own and requires manual stretching to help relax and lengthen the shortened muscle. Spasms and cramps can be mild or extremely painful. While they can happen to any skeletal muscle, they are most common in the legs and feet and muscles that cross two joints (the calf muscle, for example). ^

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